Medicare's open-enrollment season will be -2-

"Just because you had something in your 2024 Part D formulary does not give you assurance that it's going to be in your 2025 Part D formulary," said Delp.

Another way to keep prescription costs down, Purvis suggested: Ensure that the pharmacies you prefer are in the Part D plan's preferred network.

The new Medicare prescription payment plan

Something else coming in 2025 you'll need to make a decision about during open enrollment: the new, little-known Medicare Prescription Payment Plan, sometimes dubbed MP3.

A striking 92% of Medicare beneficiaries surveyed by the Pan Foundation hadn't seen, read or heard about it.

Under the current Medicare prescription-drug system, people with Part D plans often get walloped with huge out-of-pocket costs every January and February - sometimes thousands of dollars - because they haven't reached their annual deductible amount and their insurance coverage hasn't kicked in.

The 2022 Inflation Reduction Act created the MP3 to avoid this problem. If you sign up for MP3 as part of your 2025 Part D plan, you'll be put on a monthly payment plan for your Part D prescriptions (not Part B ones), smoothing out-of-pocket costs during the year.

But, Delp said, "I think the prescription payment plan is going to be quite confusing for the consumer." The reason: Part D policyholders with MP3 will get two bills each month - one for their prescriptions and one for their premiums.

You'll want to run the numbers for your Part D prescriptions in 2025 to determine whether the payment plan is worth the extra hassle.

Signing up for MP3 might be unnecessary if you'll get financial assistance for your medications from either a state-run Medicare Savings Program or Medicare's low-income subsidy program, your pharmaceutical manufacturers, or groups like the Pan Foundation.

Jennifer Teague, director of health coverage and benefits for the National Council on Aging, estimates that Medicare's Extra Help subsidy program saves people roughly $5,900 a year. To qualify, your income must be lower than roughly $23,000 (about $31,000 for married couples) and you must have limited assets.

"There's a lot of complicated math that goes into how you figure out whether you should enroll [in MP3] or not," said Purvis.

Delp said snowbirds thinking about signing up for MP3 will want to be sure their mail gets forwarded to their winter locale so they won't miss seeing their Part D plans' new monthly bills.

Getting help during Medicare open enrollment

You don't need to make Medicare open-enrollment decisions alone.

Medicare's website, Medicare.gov, and the agency's annual "Medicare and You" booklet (also on the Medicare site) explain the ins and outs of traditional Medicare, Medicare Advantage plans and Part D plans.

The Medicare site's Plan Finder can show you details on all the Part D and Medicare Advantage plans that will be available in 2025 where you live.

Medicare also has a customer-support line: 1-800-MEDICARE.

Another useful resource: your State Health Insurance Assistance Program, or SHIP (national phone number: 877-839-2675).

Its independent, unbiased experts can talk to you by phone or in person to clear up confusion and answer your questions about Medicare for 2025. SHIP volunteers, however, can't tell you which Part D or Medicare Advantage plan to get.

A Medicare agent or broker can assist you in selecting an appropriate Part D or Medicare Advantage plan for 2025, too. But know that these pros are paid by the insurers they represent.

"I think people just need to be mindful that agents may not necessarily provide the full universe of plan options that are available to you," said Purvis.

The Certified Medicare Agents Directory has an online list of Part D and Medicare Advantage agents, and the National Council on Aging has given Fidelity Medicare Services, a brokerage, its Standard of Excellence.

"I really like it when people talk to an agent or broker and then reach out to us to confirm what they heard," said Fajuri of California's SHIP plan, HICAP.

Timing your open-enrollment decisions

Because Medicare open enrollment will be more complicated than usual, experts advise starting your research soon.

"The more time you give yourself, the better," said Purvis. "There is a lot to wrap your head around."

If you wait until late November or early December to get help from a Medicare agent, broker or SHIP counselor, you'll likely encounter trouble getting on their calendar.

"Many [SHIP] programs book up for open-enrollment appointments as early as early November," said Fajuri.

Soistman, of eHealth, has asked Medicare to extend open enrollment by five or six days this year to give applicants, insurers, agents and Medicare staffers more time. He hasn't heard back.

But Philip Moeller, author of the new book "Get What's Yours for Medicare," recommends not locking in your open-enrollment decisions early. He suggests waiting until mid-November or even a little later.

By then, he believes, you'll be able to amass all the information you need from prospective Medicare Part D and Advantage plans, analysts and your doctors to make well-researched decisions.

But don't delay too long. If you wait until late December, the plans you want may not be able to complete your open-enrollment process before coverage begins Jan. 1.

-Richard Eisenberg

This content was created by MarketWatch, which is operated by Dow Jones & Co. MarketWatch is published independently from Dow Jones Newswires and The Wall Street Journal.

(END) Dow Jones Newswires

10-02-24 0700ET

Copyright (c) 2024 Dow Jones & Company, Inc.